Individual
BURKE DICKENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
4420 LAKE BOONE TRL, RALEIGH, NC 27607
(919) 784-3100
Mailing address
2411 FORDCREST DR, APEX, NC 27502-6288
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5007602
NC
363LA2200X
Adult Health Nurse Practitioner
5007602
NC
Other
Enumeration date
03/24/2015
Last updated
03/30/2021
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